Has the Age-Adjusted Premature Mortality Rate Changed Over Time?
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Discussion
Overall
The overall age-adjusted premature death rate decreased significantly from 2005-2007 to 2012-2014 then increased slightly from 2012-2014 to 2015-2017 for Sonoma County, California, and the United States (Figure 19). In 2015-2017, premature death rates for Sonoma County, California, and the United States were all significantly less than their respective 2005-2007 rates. The Sonoma County rate decreased by about 13% from 2005-2007 to 2012-2014 compared to a 16% decrease for California and a 9% decrease for the United States. From 2012-2014 to 2015-2017 the rate increased by 2% for Sonoma County, 1% for California, and 5% for the United States.
Figure 19. Age-adjusted premature death (YPLL-75) rates, three-year average, Sonoma County, California, and the United States 2005-2007 to 2015-2017
Source: California Department of Public Health, California Integrated Vital Records System, 2015-2017; Accessed 4/8/2019.
By Sex
The overall premature death rate decreased significantly from 2005-2007 to 2015-2017 for Sonoma County women (Figure 20). For men in the county the premature death rate decreased significantly from 2005-2007 to 2012-2014 then increased from 2012-2014 to 2015-2017, indicating that the increase in the overall premature death rate during this time period was driven by an increase in the premature death rate for men. From 2012-2014 to 2015-2017 the premature death rate for males increased from 1.5 times to 1.8 times that for females.
Figure 20. Age-adjusted premature death (YPLL-75) rates by sex, three-year moving average, Sonoma County 2015-2017
Source: California Department of Public Health, California Integrated Vital Records System, 2015-2017; Accessed 4/8/2019.
By Race/Ethnicity
Premature death rates were significantly lower in 2015-2017 than 2005-2007 for African American/Black, Hispanic/Latino, and white, non-Hispanic residents, while rates for Sonoma County American Indian/Alaska Natives and Asian/Pacific Islanders were unchanged (Figure 21). The premature death rate for American Indian/Alaska Native residents increased significantly from 2005-2007 to 2011-2013, decreased from 2011-2013 to 2014-2016, then increased significantly from 2014-2016 to 2015-2017. The premature death rate for African American/Black residents decreased about 48% from 2005-2007 to 2014-2016 but the rate did not change significantly from 2014-2016 to 2015-2017. The premature death rate for Hispanic/Latinos decreased by 28% from 2005-2007 to 2013-2015 but increased significantly in 2014-2016 and again in 2015-2017.
Figure 21. Age-adjusted premature death (YPLL-75) rates by race/ethnicity, three-year moving average, Sonoma County 2015-2017
Source: California Department of Public Health, California Integrated Vital Records System, 2015-2017; Accessed 4/8/2019.
By Cause
Changes in age-adjusted premature death rates varied by cause of death. From 2005-2007 to 2015-2017 premature mortality rates decreased by 20% for cancer and by 18% for heart disease (Figure 22). This is likely due to an increase in survival with the disease and not a decrease in prevalence of these diseases.5-6The premature death rate for unintentional injury decreased by over 35% from 2005-2007 to 2011-2013, then increased 33% from 2011-2013 to 2015-2017 largely due to an increase in premature death from unintentional drug overdoses. From 2014-2016 to 2015-2017, the premature death rate for unintentional injury did not change significantly. After decreasing significantly from 2007-2009 to 2011-2013, the premature death rate due to suicide increased by 32% (significantly) from 2011-2013 to 2015-2017, mirroring a national trend.
Figure 22. Age-adjusted premature death (YPLL-75) rates by cause of death, three-year moving average, Sonoma County 2015-2017
Source: California Department of Public Health, California Integrated Vital Records System, 2015-2017; Accessed 4/8/2019.